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Topic Review
Contemporary Antiretroviral Drugs
Contemporary antiretroviral agents afford enhanced potency and safety for patients living with HIV. Newer antiretroviral drugs are often better tolerated than those initially approved in the early stages of the HIV epidemic. While the safety profile has improved, adverse drug reactions still occur. We have segregated the antiretroviral agents used in contemporary practice into class groupings based on their mechanism of antiviral activity (non-nucleoside reverse transcriptase inhibitors, nucleoside reverse transcriptase inhibitors, integrase inhibitors, protease inhibitors, and entry inhibitors) while providing a review and discussion of the hepatoxicity seen in the most relevant clinical literature published to date. Clinical literature for individual agents is discussed and agent comparisons afforded within each group in tabular format.
  • 852
  • 25 May 2021
Topic Review
Implementation of Pharmacogenetics - The PriME-PGx Initiative
Pharmacogenetics is the medical discipline born in the 1950s that studies the role of genetic variation affecting drug response or adverse reactions to drugs. Implemented in the clinical practice, this discipline helps to bring a personalized treatment to each patient. Consequently, ineffective or potentially toxic treatments are avoided or optimized. Here, we present the experience in Clinical Pharmacogenetics Implementation at the Clinical Pharmacology Department, Hospital Universitario de La Princesa.
  • 850
  • 10 Dec 2021
Topic Review
ALK Inhibitors in NSCLCs
The discovery of the EML4-ALK fusion gene in a limited subset of patients affected by NSCLC and the subsequent clinical development of crizotinib in 2011 has been an impressive milestone in lung cancer research. Unfortunately, acquired resistances regularly develop, hence disease progression occurs. Afterward, modern tyrosine kinase inhibitors (TKIs), such as ceritinib, alectinib, brigatinib, and lorlatinib, have been approved by the Food and Drug Administration (FDA) for the management of anaplastic lymphoma kinase (ALK)-positive NSCLCs. Several compounds are currently under investigation to achieve the optimal strategy of therapy. 
  • 849
  • 13 Jan 2021
Topic Review
Disparities in Prevalence and Barriers to Hypertension Control
Controlling hypertension (HTN) remains a challenge, as it is affected by various factors in different settings. The prevalence of hypertension control in the low and middle-income countries and high-income countries studies ranged from (3.8% to 50.4%) to (36.3% to 69.6%), respectively. Concerning barriers to hypertension control, patient-related barriers were the most frequently reported, followed by medication adherence barriers, lifestyle-related barriers, barriers related to the affordability and accessibility of care, awareness-related barriers, and, finally, barriers related to prescribed pharmacotherapy.
  • 848
  • 09 Dec 2022
Topic Review
Mesoporous Silica Nanoparticle-Mediated Drug Delivery in Breast Cancer
Breast cancer (BC) currently occupies the second rank in cancer-related global female deaths. Although consistent awareness and improved diagnosis have reduced mortality, late diagnosis and resistant response still limit the therapeutic efficacy of chemotherapeutic drugs (CDs), leading to relapse with consequent invasion and metastasis. Treatment with CDs is indeed well-versed but it is badly curtailed with accompanying side effects and inadequacies of site-specific drug delivery. As a result, drug carriers ensuring stealth delivery and sustained drug release with improved pharmacokinetics and biodistribution are urgently needed. Core–shell mesoporous silica nanoparticles (MSNPs) have been a cornerstone in this context, attributed to their high surface area, low density, robust functionalization, high drug loading capacity, size–shape-controlled functioning, and homogeneous shell architecture, enabling stealth drug delivery.
  • 847
  • 02 Aug 2023
Topic Review
Lopinavir/Ritonavir
Lopinavir-ritonavir (LPV/RTV) is a human immunodeficiency virus (HIV) antiviral combination that has been considered for the treatment of COVID-19 disease.
  • 844
  • 07 Dec 2020
Topic Review
Carriers Containing Phospholipid Soft Vesicles
Topical drug delivery has many advantages over other ways of administration, having increased patient compliance, avoiding the first-pass effect following oral drug administration or not requesting multiple doses administration. However, the skin barrier prevents the access of the applied drug, affecting its therapeutic activity. Carriers containing phospholipid soft vesicles are a new approach to enhance drug delivery into the skin and to improve the treatment outcome. These vesicles contain molecules that have the property to fluidize the phospholipid bilayers generating the soft vesicle and allowing it to penetrate into the deep skin layers. Ethosomes, glycerosomes and transethosomes are soft vesicles containing ethanol, glycerol or a mixture of ethanol and a surfactant, respectively. 
  • 844
  • 17 Dec 2021
Topic Review
Ultrasound-Mediated Gene Delivery
Recently, various drug and gene delivery systems employing physical energy, such as ultrasound, magnetic force, electric force, and light, have been developed. Ultrasound-mediated delivery has particularly attracted interest due to its safety and low costs. Ultrasound exposure increases cell membrane permeability and facilitates the delivery of drugs or genes into cells. Its delivery effects are also enhanced when combined with microbubbles or nanobubbles that entrap an ultrasound contrast gas. Furthermore, ultrasound-mediated nucleic acid delivery could be performed only in ultrasound exposed area. 
  • 843
  • 07 Dec 2020
Topic Review
Driver Genes in Colorectal Cancer
Colorectal cancer is one of the most prevalent cancer types. Although there have been breakthroughs in its treatments, a better understanding of the molecular mechanisms and genetic involvement in colorectal cancer will have a substantial role in producing novel and targeted treatments with better safety profiles.
  • 841
  • 30 Jun 2022
Topic Review
Metabolic Approaches for Treatment of Dilated Cardiomyopathy
In dilated cardiomyopathy (DCM), where the heart muscle becomes stretched and thin, heart failure (HF) occurs, and the cardiomyocytes suffer from an energetic inefficiency caused by an abnormal cardiac metabolism. Although underappreciated as a potential therapeutic target, the optimal metabolic milieu of a failing heart is still largely unknown and subject to debate. Because glucose naturally has a lower P/O ratio (the ATP yield per oxygen atom), the previous studies using this strategy to increase glucose oxidation have produced some intriguing findings. In reality, the vast majority of small-scale pilot trials using trimetazidine, ranolazine, perhexiline, and etomoxir have demonstrated enhanced left ventricular (LV) function and, in some circumstances, myocardial energetics in chronic ischemic and non-ischemic HF with a reduced ejection fraction (EF).
  • 840
  • 26 Jul 2023
Topic Review
Melatonin Safety and Therapeutic Efficacy
Viral infections constitute a tectonic convulsion in the normophysiology of the hosts. The current coronavirus disease 2019 (COVID-19) pandemic is not an exception, and therefore the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, like any other invading microbe, enacts a generalized immune response once the virus contacts the body. Melatonin is a systemic dealer that does not overlook any homeostasis disturbance, which consequently brings into play its cooperative triad, antioxidant, anti-inflammatory, and immune-stimulant backbone, to stop the infective cycle of SARS-CoV-2 or any other endogenous or exogenous threat. In COVID-19, the corporal propagation of SARS-CoV-2 involves an exacerbated oxidative activity and terefore the overproduction of great amounts of reactive oxygen and nitrogen species (RONS). The endorsement of melatonin as a possible protective agent against the current pandemic is indirectly supported by its widely demonstrated beneficial role in preclinical and clinical studies of other respiratory diseases. 
  • 838
  • 03 Aug 2021
Topic Review
Oxidative stress, brain and chemotherapy
Preclinical evidence shows that several chemotherapeutic drugs widely used in cancer patients such as anthracyclines, taxanes, and platinum derivatives induced oxidative stress noted in the blood and brain, which may affect both neurons and glia cells. In animal models, the oxidative stress induced by chemotherapeutic drugs is accompanied by cognitive deficits. Administration of several antioxidants decreased or prevented these effects and helped pinpoint the potential role of antioxidants as drugs that may be able to reduce both oxidative stress and cognitive dysfunction caused by chemotherapy.
  • 838
  • 29 Mar 2022
Topic Review
Microfluidic Approaches for Affinity-Based Exosome Separation
As a subspecies of extracellular vesicles (EVs), exosomes have provided promising results in diagnostic and theranostic applications in recent years. The nanometer-sized exosomes can be extracted by liquid biopsy from almost all body fluids, making them especially suitable for mainly non-invasive point-of-care (POC) applications. To achieve this, exosomes must first be separated from the respective biofluid. Impurities with similar properties, heterogeneity of exosome characteristics, and time-related biofouling complicate the separation. Due to the compactness of state-of-the-art methods available for the separation of exosomes, quick analysis time and portable form factor, these microfluidic devices are particularly suitable to deliver fast and reliable results for POC applications. For these devices, new manufacturing methods (e.g., laminating, replica molding and 3D printing) that use low-cost materials and do not require clean rooms are presented. Additionally, special flow routes and patterns that increase contact surfaces, as well as residence time, and thus improve affinity purification are displayed. 
  • 838
  • 25 Aug 2022
Topic Review
Pharmaceutical Importance of Broccoli
Broccoli (Brassica oleracea L. var. italica) belongs to the Brassicaceae family and has more divided and stalked leaves. It has gained considerable attention due to its remarkable nutritional composition and numerous health benefits. The pharmaceutical importance of broccoli is widely known as antimicrobial, antioxidant, anticancer, immunomodulator, antidiabetic, hepatoprotective, cardioprotective, and anti-amnesic.
  • 838
  • 26 Jul 2023
Topic Review
Anticancer Activity of Napabucasin
Napabucasin (also known as BBI608) is a natural naphthoquinone originally identified as a cancer cell stemness inhibitor. Accumulated in vitro and in vivo evidence demonstrated that napabucasin showed significant anticancer effects in various types of cancers. Napabucasin showed multiple anticancer activities, including proliferation inhibition, cell death induction, cell cycle arrest, metastasis suppression, drug resistance overcoming, and stemness inhibition, etc., which were documented in many benchworks.
  • 838
  • 09 Aug 2023
Topic Review
Effects of Icaritin on Osteoporosis
Icaritin (ICT) is not only an enzyme-hydrolyzed product of icariin but also an intestinal metabolite of eight major flavonoids of the traditional Chinese medicinal plant Epimedium with extensive pharmacological activities, such as strengthening the kidney and reinforcing the bone. ICT displays several therapeutic effects, including osteoporosis prevention, neuroprotection, antitumor, cardiovascular protection, anti-inflammation, and immune-protective effect. ICT inhibits bone resorption activity of osteoclasts and stimulates osteogenic differentiation and maturation of bone marrow stromal progenitor cells and osteoblasts.
  • 837
  • 29 Mar 2022
Topic Review
Multi-Drug-Resistant Bacterial Infections
Antimicrobial resistance (AMR) remains one of the top public health issues of global concern. Among the most important strategies for AMR control there is the correct and appropriate use of antibiotics, including those available for the treatment of AMR pathogens.
  • 836
  • 15 Jun 2021
Topic Review
Nanomedicines for Overcoming Cancer Drug Resistance
Clinically, cancer drug resistance to chemotherapy, targeted therapy or immunotherapy remains the main impediment towards curative cancer therapy, which leads directly to treatment failure along with extended hospital stays, increased medical costs and high mortality. Therefore, increasing attention has been paid to nanotechnology-based delivery systems for overcoming drug resistance in cancer. In this respect, novel tumor-targeting nanomedicines offer fairly effective therapeutic strategies for surmounting the various limitations of chemotherapy, targeted therapy and immunotherapy, enabling more precise cancer treatment, more convenient monitoring of treatment agents, as well as surmounting cancer drug resistance, including multidrug resistance (MDR). Nanotechnology-based delivery systems, including liposomes, polymer micelles, nanoparticles (NPs), and DNA nanostructures, enable a large number of properly designed therapeutic nanomedicines. Nanomedicines have paved the way for effective treatment of cancer by rationally designing strategies such as passive targeted drug delivery, active targeted drug delivery, co-delivery of combinatorial agents and multimodal combination therapy, and have broad prospects in overcoming drug resistance. It is believed that nanomedicines will be an attractive strategy for reversing or overcoming cancer drug resistance.
  • 834
  • 18 Aug 2022
Topic Review
Intranasal Insulin in Ischemia, Brain Injuries and Diabetes
A decrease in the activity of the insulin signaling system of the brain leads to neurodegeneration and impaired regulation of appetite, metabolism, and endocrine functions. This is due to the neuroprotective properties of brain insulin, its leading role in maintaining glucose homeostasis in the brain, as well as in the regulation of the brain signaling network responsible for the functioning of the nervous, endocrine and other systems. One of the approaches to restore the brain insulin system is the use of intranasally administered insulin (INI). INI is being considered as a promising drug to treat Alzheimer's disease and mild cognitive impairment. Clinical application of INI is being developed for the treatment of other neurodegenerative diseases and improve cognitive abilities in stress, overwork, and depression. It has been shown that INI can be used for the treatment of cerebral ischemia, traumatic brain injuries, postoperative delirium, as well as diabetes mellitus and its complications, including dysfunctions in the gonadal and thyroid axes.
  • 831
  • 20 Apr 2023
Topic Review
Bimetallic Au–Ag Nanoparticles
Bimetallic nanoparticles (NPs) with two separate metals have been found to have stronger antibacterial potential than their monometallic versions. This enhanced antibacterial efficiency of bimetallic nanoparticles is due to the synergistic effect of their participating monometallic counterparts. To distinguish between bacteria and mammals, the existence of diverse metal transport systems and metalloproteins is necessary for the use of bimetallic Au–Ag NPs, just like any other metal NPs. Due to their very low toxicity toward human cells, these bimetallic NPs, particularly gold–silver NPs, might prove to be an effective weapon in the arsenal to beat emerging drug-resistant bacteria. The cellular mechanism of bimetallic nanoparticles for antibacterial activity consists of cell membrane degradation, disturbance in homeostasis, oxidative stress, and the production of reactive oxygen species. The synthesis of bimetallic nanoparticles can be performed by a bottom-up and top-down strategy. The bottom-up technique generally includes sol-gel, chemical vapor deposition, green synthesis, and co-precipitation methods, whereas the top-down technique includes the laser ablation method.
  • 828
  • 20 Jun 2023
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